Active Women over 50: A randomised controlled trial.

This study will use a two-arm parallel pragmatic hybrid type I effectiveness-implementation randomised controlled trial (n=1000) to test the effectiveness of the Active Women over 50 program on daily steps at 6 months compared with waitlist control among women aged 50+. Women participants aged 50 years and over will be randomly allocated in equal numbers to: a) Immediate participation in the Active Women over 50 program (intervention group), n=500 or b) Delayed participation in the Active Women over 50 program, waitlist control (control group, n=500) Intervention components The intervention group will receive immediate access to the Active Women over 50 program. The Active Women over 50 program is a remotely delivered program designed with input from end-users across urban, regional and rural geographical settings and consists of four parts: 1) telephone-based health coaching, 2) email or SMS behaviour change messages, 3) Active Women over 50 website, and 4) access to the Active Women over 50 private Facebook group. Health coaching Participants will receive two health coaching sessions, lasting up to 60 minutes, delivered by telephone or videoconference as preferred by the participant. The health coach will be a tertiary-qualified physiotherapist or other health professional trained and experienced in delivering empowerment-focused coaching to facilitate physical activity behaviour change. The first coaching session will take place within 2 weeks of randomisation, and the second session four weeks after the first. This person-centred health coaching approach will provide information and education about physical activity. The sessions will also draw on evidence-based behaviour change techniques, practice and theories to help participants set goals, action plan, and provide accountability through prompting, monitoring and reinforcement. The coach’s role is to work with participants to make achievable choices, reinforce and evaluate progress, and facilitate accountability. Participants will be encouraged to increase their physical activity as much as they are able to, and to be guided by the recommended dose of activity included in global guidelines. Types of physical activity will be dependent on the individual participant and their needs (e.g. walking, tennis, sit-to-stands). Email or SMS Behaviour Change Messages Participants will choose the type of message platform and the frequency at which they would like to receive motivational messages over the 6-month period. Participants will choose between receiving unidirectional email messages that are delivered either weekly (24 emails), fortnightly (12 emails) or monthly (6 emails) frequencies over the 6-month period; or receiving SMS messages that are delivered once per week (24 SMS messages), twice per week (48 SMS messages), or three times per week (72 SMS messages) over the 6-month period. The emails and SMS messages will include several behaviour change techniques (BCTs). Both the email and SMS messages will deliver similar content informed by behaviour change theories. Secure marketing websites will be used to send the email messages and SMS messages. Examples of behaviour change techniques that will be provided in these email or SMS messages include goal setting, planning, self-monitoring and social support. Active Women over 50 Website The website will emphasise the importance of becoming active from middle age for maintenance of health and physical function and prevention of falls in older age. Content will include three main pages “Why be active?”, “How to be active”, and “Be inspired”. The “Why be active?” page includes evidence-based information about the effect of physical activity in middle-age to maintain health, longevity, and prevent disability in older age. The “How to be active” page includes practical suggestions for becoming more active using behaviour change techniques such as SMART goal setting, self-assessment of barriers to physical activity and solution-generation and included links to resources supporting habit formation and behaviour change, and information for different health conditions and services. The “Be inspired” page includes role modelling content to inspire participant’s motivation to be physically active through video case studies and photo stories of “real life” women over 50, external podcasts, and blog posts. Participants will have the ability to access the website at their own discretion. Examples will reflect diversity of participant characteristics and place of residence (i.e., urban, regional, rural, remote). The content on this website has been specifically design for this study. Time participants spend on the website is at their own discretion. Use of the website will be monitored by Google Analytics. Active Women over 50 private Facebook group Participants will have access to a private Facebook group to support networking and social support. Participants will be able to post comments to a common page (i.e., the group wall); view and respond to others’ posts; create and post to discussion boards; and post web links, photographs, and videos. The private Facebook group will be moderated daily (Monday to Friday) by a member of the research team to ensure interactions are appropriate and relevant. Participants will be informed of the group rules, which will be both posted in the group, and pinned to the top of the group webpage. Only participants receiving the intervention will be granted access to the private Facebook group. Time participants spend on the private Facebook group is at their own discretion. Use of the Facebook group will be monitored by Facebook engagement analytics.